Effects of monthly buprenorphine extended-release injections on patient-centered outcomes: A long-term study

Abstract

The physical, social, psychological, and economic burden of opioid use disorder (OUD) is substantial. As of the year 2019, the predominant focus of OUD research was outcomes such as retention and abstinence. We report herein the effects of extended-release buprenorphine (BUP-XR), the first FDA-approved subcutaneously injected, monthly treatment for OUD, on patient-centered outcomes. Materials and methods: Patient-centered outcomes were collected during an open-label safety study of participants with OUD (NCT# 02510014) evaluating BUP-XR. Measures collected during the study included the EQ-5D-5L, SF-36v2, Treatment Effectiveness Assessment (TEA), Addiction Severity Index-Lite (ASI-Lite), employment/ insurance status questionnaire, and Medication Satisfaction Questionnaire (MSQ). Changes from baseline to end of study week 49 were analyzed using mixed models for repeated measures. "Baseline" was defined as the value collected prior to the first BUP-XR injection. Results presented are for those participants who initiated treatment on BUP-XR during the open-label study and were eligible to receive up to 12 injections. Results: Four hundred twelve participants were included in analyses; 206 participants discontinued BUP-XR prematurely. Mean EQ-5D-5L scores remained stable from baseline to end of study. Statistically significant improvements from baseline to end of study were noted for the SF-36v2 mental component summary score (difference = 5.0, 95%CI: 3.5-6.5) and 7 of 8 domain scores (P < .05 for all comparisons); the SF-36v2 physical component summary remained stable from baseline to end of study. The TEA total score (difference = 9.3 points, 95%CI: 8.0-10.5) and 4 of 4 domain scores (difference = 2-3 points per domain) significantly improved from baseline to end of study. Significant improvements (P < .05 for all comparisons) on the ASI-Lite were seen for all problem areas except alcohol use from baseline to end of study. Employment rate increased 7% whereas health insurance status remained stable from baseline to end of study. Medication satisfaction measured using the MSQ was > 88% at end of study. Conclusions: Treatment with BUP-XR monthly injections for up to 12 months in this cohort of treatment-seeking individuals with OUD led to positive PCOs and high treatment satisfaction, which correspond to personal recovery. 2017). Including patient-centered outcomes as a component of OUD

Prevalence and Geographic Distribution of Obstetrician-Gynecologists Who Treat Medicaid Enrollees and Are Trained to Prescribe Buprenorphine

“…In the general population, patients receiving buprenorphine extended-release report higher treatment satisfaction, and the medication leads to greater positive, patient-centered outcomes. 41 These benefits are particularly important in the postpartum period, a challenging time in a woman's life with drug overdoses being a leading cause of death. 42 Use of buprenorphine extended-release, however, requires that patients have a history of receiving the immediate-release formulation.…”

Review article: Rapid review of the emergency department‐initiated buprenorphine for opioid use disorder

“…50 Furthermore a community study showed that LAIB had high satisfaction (88%) and a 7% increase in employment rates. 17…”

“…3,16 In 2019, long-acting injectable buprenorphine (LAIB) became available in Australia and may alleviate some of the difficulties of long-term treatment. 17,18 Injections given weekly or monthly, could reduce the demand on GPs and pharmacies and could improve quality of life by negating the need to attend a pharmacy frequently for supervised dosing of buprenorphine. 17 Opioid withdrawal has historically been neglected in EDs.…”

“…17,18 Injections given weekly or monthly, could reduce the demand on GPs and pharmacies and could improve quality of life by negating the need to attend a pharmacy frequently for supervised dosing of buprenorphine. 17 Opioid withdrawal has historically been neglected in EDs. 19 The recommended treatments include simple analgesia, antiemetics, anti-diarrhoeal agents, benzodiazepines, antipsychotics and alpha-2 adrenergic agonists.…”

“…Currently, these few prescribers cannot meet the needs of an increasing number of patients, and the current model for OAT is inadequate for those without a regular GP or a fixed address 3,16 . In 2019, long‐acting injectable buprenorphine (LAIB) became available in Australia and may alleviate some of the difficulties of long‐term treatment 17,18 . Injections given weekly or monthly, could reduce the demand on GPs and pharmacies and could improve quality of life by negating the need to attend a pharmacy frequently for supervised dosing of buprenorphine 17 …”